LGBT seniors: Moving toward equal LTC treatment

By Vanessa De La Rosa

In 1965, Congress passed the Older Americans Act (OAA), with goals of bettering the social welfare of the elderly and aging population. The act founded the National Aging Network, comprising the federal Administration on Aging (AoA), which administers state grants to fund community planning, social services, research and development projects and personnel training in the field of aging. The AoA has authorized hundreds of local area agencies on aging within its 56 state agencies.

The OAA is paramount in the organization and delivery of social services to the elderly, providing more than $2 billion to the demographic annually. Its breadth of services includes: a program to promote independence with regard to transportation, home care, legal aid, case management and adult day care; a nutrition program specializing in home-delivered meals; an educational program to provide health services, counseling and consultation; a labor act to provide employment opportunities; grants to tribal organizations; The Long-Term Care Ombudsman Program; and public education services on elder abuse, neglect and exploitation. The act also recognizes a category of elders with “greatest social need,” referring to those who may be isolated due to racial or ethnic status.

While it seems the OAA has covered all bases in terms of assuring that our aging population is treated fairly and all their needs are met, some area agencies — and a Colorado senator — are hoping to expand the “greatest social need” label to include the elderly LGBT community.
A recent article in the Huffington Post notes that LGBT elders are more likely to live alone and without traditional care, have a smaller support system and deal with neglect and discrimination from communities, caregivers and even their own family members. It goes on to report:

“To be lesbian, gay, bisexual and/or transgender, and to age into a system that offers marginal support for dealing with the consequences of discrimination, is a harsh reality for millions of LGBT older Americans. And as more LGBT people enter retirement age over the next few decades, this hardship will amplify unless we reform our country's aging network.”

On September 19, Colorado Senator Michael Bennet introduced a bill, the LGBT Elder Americans Act of 2012, that would integrate LGBT older adults into the OAA. Not only would LGBT elders be considered as those with "greatest social need," but the bill also calls for permanently establishing the National Resource Center on LGBT Aging, the only technical assistance resource center in support of LGBT adults. The Center was established with a three-year grant from the U.S. Department of Health and Human Services in February 2010. If passed by Congress, Bennet’s amendment would ensure that elderly care providers would continue to be educated and trained on LGBT cultural competence.

Certain area agencies are ahead of the game, as a recent article suggests. Area Agency on Aging 1B, in southeast Michigan, is including specific LGBT-related questions on the agenda when older adults are consulting with counselors on where to find care or filing assistance paperwork. Questions like, “What is your sexual orientation? What is your gender identity? Do you have a spouse or partner? Do you need care providers who are sensitive to the needs of LGBT people?” can not only help to best identify where an individual should seek care, but also assure the individual that equal and fair treatment is being instituted.

In June, the Agency participated in a workshop that featured speaker Aaron Tax from SAGE (Service and Advocacy for GLBT Elders), to discuss the importance of training and care providers in LGBT competency:

Many LGBT adults are afraid to engage with the programs… This will say you have to make efforts to reach out to the LGBT community. They have to know what is available and they have to be able to access these services… This little change of the law will have a big impact.

The National Senior Citizens Law Center reported last year that 89 percent of older LGBT Americans fear they will be discriminated against at long-term care facilities. Forty-three percent of LGBT elders reported that they had already experience some sort of mistreatment in the past. The report compiled survey data from LGBT older adults, family members, friends, legal and social service providers between October 2009 and June 2010.

The LGBT Elder Americans Act of 2012 has been introduced and referred to the Senate Committee on Health, Education, Labor, and Pensions, which will consider it before possibly passing it on to the House or Senate. However, only 3 percent of all Senate bills in 2009-2010 were enacted, which does not dictate a good prognosis for Senator Bennet’s bill. There is a large LGBT community (older adults and the generations to come) who will be watching its progress closely and whose health — and quality of life — could depend on its enactment.